Maryland Department of Health and Mental Hygiene Gives Mental Health Clinics Funds To Stay Open

The Maryland Department of Health and Mental Hygiene has agreed to give several mental health clinics across the state funding that will keep the facilities, which treat a number of Medicaid beneficiaries, open "at least for the next few months," the Baltimore Sun reports. In addition to the extra funding, state health officials also have removed some of the "bureaucratic obstacles" the clinics face when seeking Medicaid reimbursements from the state. Under the new policies, clinics may provide six months of care instead of three months before the state must authorize a new treatment plan. In addition, clinics may continue to treat a patient during the reauthorization process and will be paid retroactively for any care provided before the state approves the new plan. But additional funding for the clinics seems unlikely, according to the Sun. State officials said that Gov. Parris Glendening (D) has no plans to boost the $22 million spending increase he proposed for the system in next year's budget.

Funding Crisis History
The funding and administrative adjustments come after a series of legislative hearings and "behind-the-scenes meetings" to address a situation in which many of the state's clinics face a "funding crisis," and 11 have closed in the last year. The health department maintains that the clinics have financial troubles because of "faulty business practices," including failure to submit "clean claims" for Medicaid reimbursement. However, clinics say that the funding problem is related to low reimbursement rates they receive for treating Medicaid beneficiaries. Medicaid covers about half the 80,000 people the clinics serve; Medicare covers the remainder of people, who either are elderly or have illnesses severe enough to qualify as a disability. Previously, the state paid the clinics flat, annual fees to provide services to a specific number of Medicaid beneficiaries. Four years ago, the state switched to a fee-for-service system in an effort to expand the number of people the system treats. Since that time, the number of people treated in clinics has doubled from 40,000 to 80,000; clinic operators maintain that although the state has increased funding for the system, it has not done so in proportion to the demand for services. Dr. Steven Sharfstein, the CEO of the Sheppard Pratt Health System, which operates several clinics in the state, said, "The system is a victim of its own success. What's happened is that many more patients have shown up in this redesigned marketplace than they expected." Whether the health department's latest funding allocation will keep the clinics afloat "remains to be seen," the Sun reports. "I think this will make a big difference in the administrative time and burden on providers," Herbert Cromwell, director of a statewide mental health clinic trade group, said, adding, "But I don't think it's necessarily enough to keep clinics from going under" (Bor Baltimore Sun, 1/13).